How To Evade Bipolar Disorder? What Is Its Preventive Measures

Editor's Note: This article has been recently updated with latest information and research studies.

Bipolar disorder is mentioned a lot in last few years and it is easy to think you know everything about this mental health problem. Numerous myths and misconceptions prevent us from fully understanding bipolar disorder and its effects.

Education is vital, which is why this post aims to shed light on this disorder and provide much-needed information about its causes, symptoms, and treatment options.

Keep reading to learn more about things you can do to manage this disorder or help someone else do so.

What Is A Bipolar Disorder?

The American Psychiatric Association[1] defines bipolar disorder as a brain disorder that causes severe changes in a person’s mood, energy, and ability to function.

Also known as manic-depressive illness, bipolar disorder is associated with extreme and intense emotional states that occur at distinct times, called mood episodes.

The mood episodes are depressive, manic, and hypomanic. That said, individuals with bipolar disorder also experience periods of normal moods. Despite their diagnosis, they can manage their condition and have a full and productive life.

Bipolar disorder can be categorized into three main types all of which involve changes in mood and behavior. These moods vary significantly, from extremely happy and energized behavior (manic episode) to sad, hopeless periods (depressive episodes). Hypomanic episodes are, basically, less severe manic episodes.

Three types of bipolar disorder are:

1. Bipolar I Disorder – Indicated by manic episodes lasting 7 days at least or by manic symptoms that are so intense they require hospital care. A person can also experience depressive episodes lasting for about 2 weeks. It is not uncommon for an affected individual to experience depression and manic symptoms simultaneously

2. Bipolar II Disorder – A person experiences depressive and hypomanic episodes, but manic periods described above rarely occur. This is NOT the milder form of bipolar disorder, but a separate diagnosis.

3. Cyclothymia (Cyclothymic Disorder) – Numerous periods of depressive and hypomanic symptoms lasting 1 year in children and adolescents and at least 2 years in adults. The symptoms, in this case, do not meet diagnostic criteria for hypomanic or depressive episode

Besides these three categories, the National Institutes of Mental Health[2] also adds the fourth category which includes identified and unidentified disorders with symptoms of bipolar disorder, but don’t match criteria for three groups mentioned above.

History Overview Of Bipolar Disorder

Bipolar disorder is usually considered as a novel mental illness, or a disorder characteristic of the modern age.
Wrong! You’ll be surprised to know that bipolar disorder has a long history. To truly understand this mental health problem, it is also important to know more about its historical background[3].

Let’s start with terms first; both depression or melancholy and mania have their origins in Ancient Greek.

The term melancholy derives from words melas or black and chole meaning bile. That’s because the well-known physician Hippocrates thought that melancholy or depression is caused by an excess of black bile.

On the other hand, mania is associated with multiple terms including menos which means force and passion, mainesthai referring to rage and madness, and mantis which means seer. The root of word mania is also associated with Indo-European men meaning mind.

The very origin of the history of bipolar disorder takes us to Ancient Greece, or more precisely to Aretaeus of Cappadocia who started the process of detailing symptoms in this medical field back in 1st century AD.

Aretaeus of Cappadocia was a philosopher and physician during the time of Nero or Vespasian. Although he found the strong association between depression and mania, his notes went unnoticed for centuries.

Scholars from Ancient Greece and Rome also discovered that adding lithium salts to baths can improve* the mood of depressed people and calm manic individuals. This is interesting because lithium is a common treatment for people with bipolar disorder even now, in modern ages.

Aristotle also recognized the existence of depression and not just that, he also stated that it gave inspiration to numerous artists and philosophers of his time.

Hundreds of years later, in the 17th century, Theophilus Bonet (an eminent physician and medical writer) published a book called Sepuchretum which was based on more than 3000 autopsies he performed. In the book, he links depression and mania, and he named the condition manico-melancolicus.

In 1851, French psychiatrist Jean-Pierre Falret published an article wherein he described a condition called circular insanity or la folie circulaire. Basically, he wrote about people whose mood and behavior switch from manic excitement to severe depression.

In fact, this work is usually referred to as the first documented cause of diagnosis of bipolar disorder. Besides making the first bipolar diagnosis, Falret was also the first person to report the genetic connection associated with this disorder.

During the early 1900s, Emil Kraepelin (German psychiatrist) examined the natural course of the untreated disorder and discovered it occurred in symptom-free intervals. He distinguished this disorder from schizophrenia. Kraepelin also coined the term manic-depressive psychosis.

In 1980, in the third revision of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, the term bipolar was mentioned for the first time. The term refers to two poles, depression and mania.

As you can see, bipolar disorder is not a mental health condition of modern times. The disorder has been studied throughout the history as scientists were intrigued by the presence of both maniac and depression together.

Prevalence Of Bipolar Disorder

Not only bipolar disorder has been around for centuries, it is highly prevalent at the same time. According to the National Institute of Mental Health[4]:

More than 70% of people with bipolar disorder receive at least one misdiagnosis from a doctor or psychologist

More than 10 million people will develop bipolar disorder[6] at some point in their lives

Causes Of Bipolar Disorder

The exact cause of bipolar disorder is unknown, but scientists did identify some factors that could play a role in the onset of this condition: genetics and biological differences.

Genetics

As seen above, Falret discovered that bipolar disorder could have a genetic background. Throughout the history, scientists have associated this condition with genetics particularly because one’s likelihood of developing bipolar disorder is significantly higher if that person’s sibling or parent had this diagnosis as well.

In a study that was published by the Application of Clinical Genetics[7] bipolar disorder is described as a complex, genetic disorder whose mode of transmission is still unknown. Numerous researchers speculate that common genetic variations carry the risk of manifesting the disease.

The link between genetics and bipolar disorder[8] is the strongest for individuals diagnosed with Bipolar I Disorder. Family studies show that a small number of genes of modest effect are involved in this condition.

Moreover, the family-based research identified a number of chromosomal regions linked to this disorder.

Biological Differences

In addition to genetic component, bipolar disorder is also a biological condition. Why? That’s because bipolar individuals have physical changes in their brain. The condition itself occurs in a specific area of the brain due to dysfunction of certain neurotransmitters (chemical messengers).

Just like with genetics, the relationship between these changes and bipolar disorder is unclear and a subject of numerous studies where scientists are trying to discover what really goes on in our brain.

One thing is for sure, get a detailed insight into these changes could help scientists discover the exact cause of bipolar disorder and create new treatment options.

The Journal of Affective Disorders[9] published results of a groundbreaking study which discovered that not only regional brain volumetric, thickness, and white matter make brains of bipolar people different than in healthy individuals, but there are differences in brains among people with Bipolar I and Bipolar II disorders.

Using MRI scans, scientists discovered that bipolar disorder was linked with less total brain volume and more cerebrospinal fluid.

They also found that brains of patients with Bipolar II Disorder were highly similar to healthy participants, but patients with Bipolar I Disorder had higher volume in the caudate nucleus and other areas linked to decision making and reward processing.

Although both groups had decreased* white matter integrity, participants diagnosed with Bipolar II experienced greater effects particularly in prefrontal and frontal cortex. These findings suggest that Bipolar II is to some extent a cognitive dysfunction.

Risk Factors

The truth is that everyone can develop bipolar disorder, but some people are at a higher risk than others. Below, you can see the most common risk factors that increase* your odds of developing this condition:

Family history of bipolar disorder

Drug and alcohol abuse

Dealing with physical and psychological traumatic events and stressful situations such as sexual abuse, death of loved one

Being exposed to environmental stress before you’re even born. Studies show[10] that flu during pregnancy, especially in the third trimester, increases* the child’s risk of developing bipolar disorder

Age – you are more likely to develop bipolar disorder if you’re 15 – 30 years old. As seen above, the average age of onset is 25

Symptoms Of Bipolar Disorder

Bipolar disorder is indicated by periods of intense emotions that induce changes in activity levels, sleep pattern, and other aspects of one’s life. The condition is associated with numerous symptoms occurring in manic or depressive episodes.

Symptoms Of Manic Episode

It is important to bear in mind that mania and hypomania are two types of episodes, but with same symptoms. The difference is that mania is more severe than hypomania and symptoms oftentimes require hospitalization.

Once again, hypomania is not a just milder form of mania but occurs in type II of bipolar disorder and it appears in conjunctions with intense depressive symptoms. Moving on, a manic episode is characterized by appearance of three or more following symptoms:

Abnormally jumpy, upbeat, or weird behavior

Distractibility

Euphoria i.e. exaggerated sense of well-being and self-confidence

Have trouble sleeping

High sex drive

Impulsive behavior

Increased agitation, activity, and energy levels

Lack of concentration

Not uncommon to develop a drinking problem or drug abuse

Poor decision making

Racing thoughts

Thinking you can do a lot of things at once

Unusual talkativeness and rapid speech

Symptoms Of A Depressive Episode

Depressive episodes can be intense and severe to cause a significant impact on a person’s quality of life and make it difficult to perform some day-to-day activities such as socializing, working, going to school. A typical depressive episode contains five or more symptoms such as:

Loss of interest in everything around you, even in things you used to love or felt passionate about

Suicidal thoughts and making plans about committing suicide

Weight loss* without even dieting or exercising or weight gain due to either increase* or decrease* in appetite

When To See A Doctor? How Is Bipolar Disorder Diagnosed?

Even though bipolar disorder is characterized by intense moods and behaviors, in many cases affected individuals do not recognize how much their emotional instability affects their lives and relationships. That is the reason they don’t get much-needed treatment at first.

It is not uncommon for family members or friends to notice something is wrong with an affected person and want him/her to get help, but their efforts prove to be unsuccessful.

Deciding To See A Doctor

People with bipolar disorder may enjoy, to some extent, manic episodes due to the energy boost*, increased productivity, and euphoria. That said this episode is usually followed by an emotional crash and depressive symptoms.

Although symptoms of bipolar disorder are manageable, the condition does not relieve on its own. If you experience symptoms mentioned above or euphoric episodes followed by emotional crash and depression, don’t be afraid to see a doctor.

That is the only way to get the treatment you need to feel better and put these episodes under control.

If you are worried about your friend or family member who shows strong signs of bipolar disorder, the best thing you can do is, to be honest, and urge him/her to see a doctor for their own good.

Despite living in the 21st century, we are still a society where mental illnesses are sort of a taboo, we know they exist but rarely talk about them. In turn, the bipolar person feels ashamed to seek professional help.

Showing support and helping them realize there is nothing to be ashamed about is the best strategy to inspire someone to schedule an appointment, rather than guilt-tripping the person.

Diagnosis

Think about it this way; if you want to feel better and minimize the effects of intense emotions you’re experiencing, then you have to see a doctor or mental health professional.

When you do, your doctor will do a few tests to make a diagnosis which is why it is vital to describe symptoms in detail. These tests include:

Criteria For Bipolar Disorder – Usually performed by a psychiatrist, he/she compares your symptoms with the criteria for bipolar disorder and other related conditions in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Mood Charting – Your doctor may ask you to keep a log or journal where you’ll write moods, feelings, emotions, sleep patterns, and other factors that could help with diagnosis

Physical Exam – In order to identify the existence of medical problems that could cause symptoms you experience, the doctor may also perform a physical exam and lab tests. The purpose of these tests is to rule out other conditions and ensure the diagnosis is accurate i.e. to avoid risk of misdiagnosis

Psychiatric Assessment – If you go to your physician, he/she will probably refer you to a psychiatrist where you will have the opportunity to talk about behavior patterns, feelings, and thoughts. Also, you will most likely have to complete psychological self-assessment questionnaire

Based on these tests and assessments, your doctor will make a diagnosis and recommend an adequate treatment for bipolar disorder.

How Is Bipolar Disorder Treated?

Bipolar disorder is a long-term condition, but it is manageable. In fact, with adequate treatment the outlook for a bipolar individual is favorable.

Most people who receive bipolar diagnosis and adhere to doctor-recommended medications and other treatments respond positively to those therapies. After making a diagnosis, your doctor or mental health professional will recommend the most beneficial treatment for your condition.

Since bipolar disorder is a lifelong condition, treatments are directed towards management of symptoms. Treatment options depend on a patient’s needs, below you can see the most common approaches.

Medications

Different medications are used for bipolar disorder, types and doses depend on specific symptoms you experience. Medications usually include:

Anti-Anxiety Medications – To reduce* anxiety and improve* sleep. They are prescribed only for short-term

Antidepressant- Antipsychotic – A combination of antidepressant and antipsychotic medications and usually works as both mood stabilizer and for depression treatment

Antidepressants – To manage symptoms of depression. In most cases, doctors prescribe them together with mood stabilizers

Psychotherapy

The crucial component of bipolar disorder treatment is psychotherapy. The greatest advantage of this therapy is multifaceted approach due to the ability to provide it in individual, group, and family setting. What most people don’t know is that different types of psychotherapy are available:

Cognitive Behavioral Therapy (CBT) – The primary goal of this therapy is to identify unhealthy and negative beliefs, feelings, emotions etc. and replace them with healthy alternatives. In addition to that, CBT helps identify triggers of bipolar episodes and teaches patients to manage stress and cope with traumatic situations. Benefits of CBT are well-documented. For example, a study from the PLoS One[11] confirmed that cognitive behavioral therapy is effective in decreasing* the relapse rate and improving* depressive symptoms, mania severity, and psychosocial functioning, with mild-to-moderate effect

Family-Focused Therapy – Support from family is vital for bipolar individuals. The goal of this therapy is to help you and your family recognize and manage mood swings and episodes

Interpersonal And Social Rhythm Therapy (IPSRT) – Revolves around stabilization of daily rhythms like eating and sleeping. Establishing a consistent routine contributes to mood management.
One study[12] found that IPSRT is a promising adjunctive treatment for adolescents with bipolar disorder.
Participants experienced major decreases* in manic, depressive, and general psychiatric symptoms over the 20 weeks of treatment and their overall functioning increased as well

Psychoeducation – Getting educated about bipolar disorder can help both you and your family to understand this condition better. This also helps debunk common misconceptions associated with bipolar disorder

Additional Treatment Options

Along with medications and therapy, other treatments may be added to bipolar disorder treatment, depending on your needs and severity of symptoms. For example:

Electroconvulsive Therapy (ECT) – Provides relief for patients with the severe bipolar disorder. The therapy is recommended in instances when other treatments don’t work. Also, it can be used in cases when medical conditions including pregnancy make taking medications risky.
Since ECT comes with certain side effects such as disorientation, confusion, and memory loss, you should discuss both benefits and shortcomings of this treatment with your doctor

Life Chart – Your doctor may recommend keeping a life chart where you will record symptoms, treatments, sleep patterns, energy levels, and other factors. This will help your doctor modify your treatment and make it more effective

Sleep Medications – As seen in the section with symptoms, bipolar individuals have trouble sleeping. In cases when these problems don’t improve* with treatment for bipolar, your doctor may suggest changing medications or prescription sleep pills

Supplements – Dietary supplements are a popular solution to manage symptoms of multiple diseases or to support overall health. They include natural ingredients, primarily herbs, which have been used to treat* similar symptoms for centuries.

Bear in mind that their efficacy is still a matter of debates and data on this topic is limited.

While you can buy supplements without prescription, you should ask your doctor first to make sure ingredients won’t affect the effectiveness of medications you’re taking

Self-Help Tips

In order to manage bipolar disorder successfully, you will also have to make some lifestyle changes whose purpose is to prevent cycles of behavior that aggravate the symptoms. When it comes to bipolar disorder, you are not powerless.

In fact, there are many things you can do stay on the right track. Bear in mind that these self-help tips and lifestyle modifications are NOT a replacement for medications and other treatments recommended by your doctor.

They are just complementary tools that help you maximize the benefits. Let’s take a look at some things you can do to manage your condition:

Stop Consuming Alcohol Or Using Recreational Drugs – It is not uncommon for bipolar individuals to deal with substance abuse which only worsens your symptoms.

You will find it easier to manage manic or depressive episodes and respond better to the treatment if you get help for drinking problem or drug abuse

When In Doubt, Consult Your Doctor – The biggest mistake that people repeat is refusing to ask the doctor about their concerns or medications they’re taking. You should never, under any circumstances, change the dosage or get new medications without consulting your healthcare provider.

At the same time, ask your doctor about any concerns about your disorder and treatment in general

Focus On Healthy Relationships – You should surround yourself with supportive people, particularly those who are a positive influence.

They can help you avoid unhealthy behaviors and negative feelings while providing much-needed support and motivation. This is way better than social withdrawal.

Exercise – Physical activity is a vital component of a healthy lifestyle and it can help you relieve stress or feel better when you’re experiencing a depressive episode.

For example, a study from the Frontiers in Psychology[13] found the correlation between sedentary lifestyle and bipolar disorder and confirms regular exercise can help manage depressive phase.

You don’t need a gym or expensive equipment (unless you want to), you can jog or do exercises in the comfort of your home. It’s easy to stay active and regular workouts can help you sleep better at night

Establish A Regular Sleep Pattern – Bipolar patients can find it difficult to get enough sleep. Lack of good night’s rest can worsen your symptoms and that’s something you want to avoid.

While getting sufficient sleep time is important, establishing a regular sleep pattern is paramount. Strive to go to bed every night at the same time and make sure you wake up every morning at the same time as well

Join A Support Group – These groups help you connect with other people who are dealing with the same condition. You can talk about your experiences and treatments or lifestyle modifications that help you. Above all, support groups also send a powerful message – you’re not alone in this

Manage Stress – Dealing with everyday stressors can be frustrating, particularly if you are diagnosed with bipolar disorder. Therefore, stress management is vital.

There is no “one size fits all” rule here, find an activity that you find relaxing e.g. yoga, tai chi, reading, writing, painting, jogging, walking, and use it as your relaxation technique

Eat A Healthy Diet – Bipolar disorder can affect your appetite, meaning you also have to adjust your diet to keep your weight in a healthy range. Not only that, but healthy diet also delivers your body including your brain much-needed nutrients to function properly.

Avoid or limit intake of unhealthy foods and opt for a well-balanced diet rich in fruits, vegetables, Omega-3 fatty acids.

Myths About Bipolar Disorder

Although bipolar disorder is common, it is still associated with numerous misconceptions. These myths prevent us from understanding this condition properly and they can hinder your treatment. Here are the most common myths and misconceptions about bipolar disorder.

Bipolar Is Just A Fancy Name For Mood Swings

It is not uncommon for people to underestimate bipolar disorder and assume it is just a fancy name for mood swings. Yes, bipolar disorder is associated with mood swings, but in this case, they are just one symptom of a major condition.

Moreover, mood swings in bipolar disorder are different from those of people who don’t have this condition.

When it comes to bipolar disorder, mood swings are severe, long-lasting, and affect a person’s ability to work or manage home. You can be moody, but not bipolar at the same time.

Bipolar Disorder Is The Same Thing As Schizophrenia

Bipolar disorder is oftentimes mistaken[14] for schizophrenia due to the similarity of some symptoms. It is important to clarify that they are two different disorders, but bipolar is more common than schizophrenia.

Also, symptoms of schizophrenia are more severe than those of bipolar. Patients who are diagnosed with schizophrenia also experience hallucinations and delusions. Although bipolar exhibits different behavioral episodes, people with this disorder do not hallucinate.

People With Bipolar Go Back And Forth From Depression To Mania Often

Due to the presence of two distinctive episodes, manic and depressive, many people assume bipolar person shifts back and forth from one episode to another quickly. The Jekyll-Hyde personality is one of the most common myths about this condition.

The average bipolar patient is more depressed than manic. Although both episodes occur, hence the bipolar disorder diagnosis in the first place, these changes don’t happen that quickly.

Another important thing to mention is that different people experience symptoms differently and the length of these episodes varies. Plus, as mentioned above, a bipolar person can still experience periods of normal behavior without these episodes.

Bipolar Disorder Affects Only Certain People

Everyone can develop bipolar disorder. Unlike many other conditions which are more prevalent among certain ethnic or race groups or affect either men or women predominantly, the bipolar disorder occurs in all groups. You are not at a higher risk of developing this disorder just because you’re a man or woman, black or white.

Children Can’t Get Bipolar Disorder

When we think of brain disorders and mental health conditions, we tend to associate them with adulthood. Children can develop them too, and bipolar disorder is not an exception.

In fact, children as young as 6 can develop this condition and symptoms can even induce suicidal thoughts in a child.

The biggest problem here is that bipolar children experience many periods of depression before the first manic episode, which is why it becomes difficult to diagnose this disorder.

A Manic Episode Is Fun

Extreme happiness, high mood, energy boost*, and other symptoms may make it seem that manic episodes are fun. The reality is much different. During a manic episode, a bipolar person loses control, feels anxious, angry, and frustrated.

They can also become reckless without even being aware of it. Needless to mention that manic episode also induces risky behaviors.

In some people, primarily among those with type I, manic episodes can be so intense that a patient fears the next episode and will do everything it takes to prevent or make it go away. To conclude, manic episodes are NOT fun.

Bipolar People Are Violent, Criminals, And A Threat To Society

As mentioned above, even in the 21st-century mental illnesses are still a sort of a taboo and society has a weird way of understanding these conditions.

It is not uncommon for people to assume that all people with a psychological condition are criminals. Evidence shows[15] that people with a mental illness are more likely to be victims of violence than perpetrators.

Celebrities With Bipolar Disorder

Bipolar disorder is a common condition that affects millions of people in the US and worldwide. This also includes celebrities who deal with the same problem. Thanks to their high-profile lifestyles, they shed more light on bipolar disorder and raise awareness.

This explains why we are witnessing small, but significant improvements in the way bipolar disorder is discussed or understood. Below, you can see a list of celebrities who deal with the same problems that you (or someone you know) have:

Demi Lovato – She learned about her bipolar diagnosis in rehab. She struggled with a depressive episode and didn’t know what was wrong with her, but never talked to anyone about it, which led to unhealthy behaviors. Now, she’s outspoken about her struggles and functions normally even with bipolar diagnosis

Vivien Leigh – Popular Scarlett O’Hara from Gone with the Wind had bipolar disorder and due to unpredictable behavior, she lost many parts. Back then, there were no medications and treatments that are used now for managing this condition

Carrie Fisher – Princess Leia had a tumultuous childhood and struggled with drug and alcohol addiction. In her early 20s, Fisher was diagnosed with hypomania, but struggled for years to accept the diagnosis

Linda Hamilton – She struggled with symptoms of bipolar disorder for 20 years before seeking help for her condition. Now, she takes her medication and is outspoken about this disorder

Sinead O’Connor – In her 20s, O’Connor suffered from depression but was diagnosed with bipolar when she was 37

Vincent Van Gogh – One of the most important artists in history was associated with epilepsy, depression, psychotic attacks, and bipolar disorder.

Scientists speculate that the last theory is the most believable because there are records of two distinct episodes of reactive depression and they were followed by sustained periods of enthusiasm and high energy

Resources

Nowadays, bipolar persons have plenty of resources which provide information about this disorder and explain how to treat* it properly. Some resources that you or someone you know can use are:

Depression And Bipolar Support Alliance (DBSA)[16] – National organization that focuses on supporting people with depression and bipolar disorder. The organization also provides a support network for parents of children who suffer from mood disorders

National Alliance On Mental Illness[17] – Works to support and educate the public about mental disorders in order to improve* the quality of life for patients who deal with these conditions

American Psychiatric Association[18] – An organization of psychiatrists who provide compassionate care and effective treatment for all people with mental and behavioral disorders

Conclusion

Bipolar disorder is a common, but still poorly understood, condition that is indicated by manic or depressive episodes which affect a person’s quality of life.

It is of huge importance to see a doctor if symptoms of bipolar depression occur. With accurate diagnosis and treatment which includes medications, therapy, and lifestyle modifications, you can function normally and avoid your condition from preventing you from reaching your full potential in personal and professional life.

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